The Influence Of Self-efficacy And Self-care Joint Intervention On The Quality Of Life Of Esophageal Carcinoma Patients Receiving Radiation

Objective:To explore the influence of self-efficacy and self-care joint intervention on the quality of life of esophageal carcinoma (EC) patients who are receiving radiation and evaluate the prospect of clinical application based on the effect of intervention in order to draw up feasible nursing intervention model, and improve the quality of life of EC patients.Methods:The research was an interventional study, and used the method of convenience sampling to select 88 EC patients receiving definitive radiotherapy who came from the radiology department of one cancer hospital in Shandong from Jun 2013 to Dec 2014. Among of them,44 patients with EC from Jun 2013 to Dec 2013 were ranked control group, and 44 EC patients from Jan 2014 to Nov 2014 were ranked experimental group. The patients in the control group received EC routine nursing, while the experimental group received joint nursing intervention which improved self-efficacy and self-care ability on the basis of routine nursing care. The interventional effect of those two groups were compared with each other, using questionnaires included general self-efficacy scale (GSES), the exercise of self-care agency (ESCA), the European quality of life instrument for cancer patients-esophageal cancer (EORTCQLQ-C30) on the day before radiation and in one month after the completion of radiation. The patients in experimental group were also evaluated in the same way on the very day of radiation so that the change of interventions effect over time can be studied for EC patients. The statistical software SPSS for windows version 17.0 was used for data analysis.Results:1.40.48% EC patients perceived higher levels,54.76% patients perceived medium levels and 4.76% patients perceived lower levels of self-efficacy in experimental group; while 77.27% patients perceived medium levels,20.46% patients perceived lower levels and 2.27% perceived higher levels in the control group. In addition, in experimental group,80.95% patients perceived higher levels, 19.05% patients perceived medium levels and none perceived lower levels of self-care ability; while in the control group,6.82% patients perceived higher levels, 90.91% patients perceived medium levels, and 2.27% perceived lower levels.2. Comparing the self-efficacy of two groups, both self-care ability and quality of life in the experimental group were significantly improved (P<0.01).3. The scores of self-efficacy, self-care ability and quality of life in the experimental group all improved over time (P<0.01). The life quality scores of patients were statistically different between the pre-radiation, the very day of radiation and after the intervention (P<0.05).4. Self-efficacy, self-care ability and its dimension scores had a significant positive relationship (P<0.01); self-efficacy, quality of life and its functional areas scores had a significant positive relationship (P<0.01); Self efficacy and the symptoms of fatigue, pain, loss of appetite, constipation were negatively correlated (P<0.01).self-care ability and its dimension and quality of life and functional areas were highly positive correlation (P<0.01), symptoms and individual items of fatigue, pain, insomnia, loss of appetite, constipation and self-care ability and all dimensions were negatively correlated (P<0.01).5. According to the stepwise multiple regression analysis of the influencing factors related to the quality of life of patients with esophageal carcinoma after radiotherapy were lesion location OB=-8.633, P<0.01) with self-care ability (B=0.127, P<0.01), clinical stage (B=-4.124, P<0.01), self-efficacy (B=0.502, P<0.01)Conclusion:1. The level of self-efficacy and self-care ability of patients in control group was medium, while the level of those in experimental group was high.2. Self-efficacy and Self-care joint intervention was the effective way to improve self-efficacy, self-care ability of esophageal carcinoma patients receiving radiation. And with the advance of radiotherapy, self-efficacy and self care ability is gradually increased.3. Self-efficacy and Self-care joint intervention was the effective way to improve the quality of life of esophageal carcinoma patients receiving radiation. But the quality of life of the patients at the end of radiotherapy should be lower than that before radiotherapy, we should focus on strengthening intervention during radiotherapy.4. The relationship between the scores of self-efficacy, self-care ability and its dimensions, and the quality of life and its dimensions presented highly positive correlation.5. The main factors that affect the quality of life of patients with esophageal carcinoma after radiotherapy were lesion location,self-care ability, clinical stage, self-efficacy,among which lesion location and the self-care ability were the most important factors.